Required Forms (all patients)
PHC Release of Information (English) / (Spanish)
Communications Preferences (English) / (Spanish)
PHC Notice of Privacy Practices (English) / (Spanish)
Patient Information
Admission for Services / Admisión a los servicios
Patient Rights and Responsibilities/ Derechos y responsabilidades del paciente
Facility Rights and Responsibilities / Derechos y responsabilidades de las instalaciones
Grievances and Complaints / Quejas y reclamaciones
Imposition of Charges / Imposición de cargos
Cap on Charges / Límite máximo de cargos
Cap on Specialty Charges / Límite máximo de cargos por servicios especializados
Emergency Financial Assistance Request
Consent for an Assistor